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The Achilles tendon supports everyday movements like walking, twisting, running, and jumping. It serves as the crucial link between the calf muscles and the heel bone, allowing your foot to flex and push off the ground with each step. This tendon absorbs the impact of these movements, helping to support your body weight and generate the power needed for activities that involve speed, agility, or explosive motion. Without a healthy Achilles tendon, even basic movements would become difficult, making its function essential not only for athletes but for anyone leading an active lifestyle.
Physically active people and athletes are prone to developing Achilles tendonitis (inflammation of Achilles tendon) due to multiple causes discussed ahead. This condition can be particularly troublesome for athletes because it causes limitations in virtually every athletic movement, from jumping to running.
Identifying early signs of Achilles tendon inflammation can aid in preventing further damage and effectively managing the condition, these include:
● Acute pain along the Achilles tendon, often associated with stiffness. The pain and stiffness are usually more severe in the morning
● Localized swelling or thickening along the Achilles tendon
● Reduced mobility and exacerbation of pain when flexing the foot
● Severe injury may cause a crackling sound with movement
Read on to explore the different causes that trigger inflammation of Achilles tendon and various management strategies.
Causes of Achilles Tendonitis
Repetitive stress and strain on the Achilles tendon are the primary triggers that cause tendonitis. The following risk factors are the primary source of Achilles tendonitis in active people.
Overuse and Repetitive Motion: One of the most prevalent causes is overuse and repetitive motion. Athletes who regularly perform high-impact activities such as running, jumping, sprinting, or sudden bursts of speed can place excessive strain on the Achilles tendon. Abruptly increasing the intensity or frequency of these activities without allowing sufficient time for rest and recovery can result in inflammation.
Improper Footwear: Shoes that provide inadequate support or cushioning can play a significant role in the onset of Achilles tendonitis. For example, running in worn-out shoes or those with insufficient arch support can place excessive stress on the Achilles tendon.
Sudden Increase in Activity Level: Rapidly escalating the intensity or duration of physical activity without giving your body time to adapt can put significant strain on the Achilles tendon. Allowing your body adequate time to adjust to increased demands is crucial for preventing overuse injuries and ensuring that the tendon can handle the new level of activity without becoming compromised.
Biomechanical Issues: Abnormal foot mechanics, such as supination (outward bending of the foot) or overpronation (inward bending), can create uneven stress on the Achilles tendon. Poor alignment and gait issues can further increase the risk of developing tendonitis by exacerbating this uneven strain.
Tight Calf Muscles: Tight calf muscles can heighten the strain on the Achilles tendon. When the calf muscles lack flexibility, they exert additional pull on the tendon, which can lead to irritation and inflammation.
Age and Gender: Tendonitis becomes more prevalent with age, particularly in individuals who suddenly ramp up their activity levels or take up new sports. As we age, tendons lose their elasticity, which makes them more vulnerable to injuries.
Management and Treatment Options
A multifaceted approach is required to manage Achilles tendonitis. These may include a combination of rest, rehabilitation, and, in some cases, medical and surgical interventions.
1. Activity Modification and Adequate Rest
The first step in treating Achilles tendonitis is to give the tendon time to rest. This doesn’t mean stopping all activity but reducing actions that worsen the condition. Low-impact exercises like swimming or cycling can help you stay fit without straining the tendon.
2. Physical Therapy
Physical therapy is key to recovery. A therapist can create a custom exercise plan to strengthen calf muscles, improve flexibility, and fix any biomechanical problems. Eccentric exercises, where the muscle lengthens under tension, are especially helpful.
3. Footwear and Orthotics
Custom orthotics can help fix biomechanical problems that lead to Achilles tendonitis. These inserts offer better arch support and improve foot alignment. Wearing well-cushioned, supportive shoes is also important to lessen the strain on the Achilles tendon.
4. Ice
Applying ice wrapped in a cloth to the affected area can help reduce inflammation and ease pain in the injured Achilles tendon. To do this safely, you can place an ice pack wrapped in a towel or or a bag of frozen peas on the injured tendon for several minutes. It’s important to repeat this several times throughout the day, especially after activities that might aggravate the condition, such as walking, running, or standing for long periods. Ice helps to numb the area, reduce swelling, and prevent further inflammation, making it an effective part of the recovery process. Always ensure there is a barrier between the ice and skin to prevent frostbite.
5. Non-Steroidal-Anti-Inflammatory Drugs (NSAIDs)
Medications like ibuprofen or naproxen can be useful for reducing inflammation and managing acute pain associated with Achilles tendonitis. These medications can offer short-term relief, especially during flare-ups. Consulting a healthcare provider before starting any OTC painkiller is crucial to ensure it’s safe for you and to explore alternative treatment options if necessary.
6. Stretching and Strengthening Exercises
As the acute pain lessens, gentle stretching and strengthening exercises become important. Calf stretches can increase flexibility and ease the strain on the tendon. Eccentric strengthening exercises, like slowly lowering the heel from a raised position, are especially effective. These exercises aid in repairing and strengthening the tendon.
Advanced Treatment Options
For chronic or severe Achilles tendonitis that doesn’t improve with standard treatments, advanced options like shockwave therapy and surgical interventions might be considered.
It is a non-invasive therapy that has shown potential for chronic Achilles tendonitis. Also known as extracorporeal shock wave therapy (ESWT), it stimulates the body's natural healing process by applying high-energy shock waves to the affected area. Here’s how it works and why it can be effective:
Mechanism: Shockwave therapy sends acoustic waves (a type of sound waves) through the skin to target the tendon. This stimulation boosts blood flow, encourages collagen production, and speeds up tissue repair. The improved circulation helps reduce pain and supports the healing of damaged tendon fibers.
Benefits: Many athletes find shockwave therapy effective for easing pain and enhancing function, particularly when other conservative treatments haven't worked. The procedure is relatively quick, though multiple sessions are often needed for the best results.
Considerations: Shockwave therapy is usually well-tolerated. Contraindications include pregnancy, infections, or certain medical conditions that could worsen with the treatment.
Treatment is available at our practice visit: https://www.physio4quality.com/shockwave-therapy
2. Platelet-Rich Plasma (PRP) Injections
PRP injections is another advanced treatment option. This involves injecting a concentration of platelets derived from your own blood into the affected area. PRP, or platelet-rich plasma, is rich in growth factors that help promote healing and tissue regeneration. The process starts with drawing a small amount of your blood, which is then processed to concentrate the platelets.
This concentrated plasma is injected directly into the injured area. PRP injections are gaining popularity because they have the potential to speed up recovery, enhance tissue repair, and reduce inflammation. This approach leverages your body's own healing properties to address chronic issues and improve overall function.
3. Surgical Intervention
In rare cases where both conservative and advanced treatments don't relieve the symptoms, surgery may be needed. This could involve removing damaged tissue or repairing the tendon. Surgery is usually considered a last resort and is recommended only after all other options have been tried.
Conclusion
Achilles tendonitis can be a frustrating challenge for active individuals, but with proper management and treatment, recovery is possible. By understanding its causes and using effective strategies, including advanced treatments like shockwave therapy, athletes can return to their activities stronger and more resilient. Balancing activity with rest, wearing appropriate footwear, and using proper technique is crucial for preventing future injuries. Stay proactive about your health and wellness, and you’ll be back on your feet in no time.
Book your appointment now for an assessment and treatment plan to get you back on track.
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